Abstract:

BACKGROUND: Pith decompression and tantalum rod insertion for treatment of early femoral head necrosis, especially suitable for femoral head necrosis Steinberg Ⅰ and Ⅱ, which not only can solve the pain, but also can prevent and cure the collapse of the femoral head necrosis in the progress of delay, and is a worthwhile new method.
OBJECTIVE: To explore indication and clinical curative effect on porous tantalum rod insertion for treatment of femoral head necrosis.
METHODS: Sixteen cases of 18 hips with femoral head necrosis were included. According to Steinberg staging: Ⅰperiod 5 hips, Ⅱ period 12 hips, Ⅲ period A1hip. The lateral small incision approach was used to undergo pith decompression and porous tantalum rod insertion. After 6 weeks, weight loading was prohibited, part weight loading was allowed from 6 to 10 weeks, and gradually transition to full weight loading. The improvement of hip joint function after insertion was systematically evaluated by Harris rating system. At 24 hours, 1, 3, 6, 12 months after insertion, lateral X-ray film was disturbed, and the repair and necrosis progress was observed.
RESULTS AND CONCLUSION: Sixteen cases of 18 hips were obtained for follow-up (7-13 months). The last follow-up after insertion was undergo clinical efficacy evaluation, optimal for 11 patients of 12 hips, benign for 4 patients of 5 hips, general for 1 patient of 1 hip. Patients with Harris score preoperative 49-83 points, the average 65.3±8.6 points, increased to the postoperative 75-97 points, the average 88.2±9.3 points, there was significant difference between preoperative and postoperative (P < 0.05) . Follow-up radiography hip imaging displayed stably and no necrosis progress in femoral head. The curative effect on porous tantalum rod prosthesis insertion for treatment of femoral head necrosis is confirmed, especially for Steinberg Ⅰ period,Ⅱ period and collapse of smaller Ⅲ A period femoral head necrosis of patients.